What we’re reading: The interwoven lessons of infectious disease and opioid responses

An Opioid Crisis Foretold – This piece from the editorial board of The New York Times provides a brief history of errors in practice and policy that have led to, and sustained previous epidemics of opioid use. Among the lessons recounted here that should have averted and still could inform responses to the present opioid crisis in America, the writers note, was the early AIDS epidemic, which exploded worldwide during decades of neglect, and only began to reverse course when policy makers recognized that the epidemic represented “a complex, multidimensional problem and tackled it by funding prevention, treatment, support services and research.” The piece also notes that the annual death toll caused by opioid use is now approaching that of AIDS at its peak. What the piece does not address is the rising incidence of HIV and other infectious diseases caused by the opioid epidemic, and that funding as well as measures must be integrated into prevention, treatment, support services and policies to address those, too.

An epidemic of epidemics . . . This Vox story from a month earlier rounds out the Times piece with lessons from the current opioid epidemic, noting that its accompanying outbreaks of hepatis C and HIV remain “largely overlooked and gravely underfunded,” and adding that “Out of the $15 billion hospitals billed to treat opioid patients in 2012, more than $700 million went to treating patients with infections.”

A sign of the times – Public health officials are looking at the factors behind a doubling of HIV infections over the last year in Northeast Massachusetts, where injection drug use has been rising steadily over the past decade. Homelessness and increasing use of fentanyl, are among the suggestions noted here. In any case, the article notes, the rising rates of HIV are not surprising to infectious disease physicians in Kentucky and West Virginia who have seen the impacts of the opioid crisis in their states.

Falsehoods and facts about drugs and the people who use them – A member of the Global Commission on Drug Policy, and the former president of Timor-Leste, José Ramos-Horta, adds international perspective on the common ground of uninformed drug policies’ impacts, noting “If an individual’s drug use leads to health problems, finding care is often a challenge because services do not exist, the individual fears legal repercussions, or faces prejudice — even in the health care setting. This is a clear violation of the Universal Declaration of Human Rights, which states that everyone has an equal right to health.”